Influence de la greffe rénale sur la sexualité

Abstract : Introduction. Sexual disorders are highly prevalent among patients with chronic kidney disease; less studied in women it can reach 70% in men with severe chronic renal failure. The objective of our study was to assess the influence of renal transplantation in a mixt population of terminal chronic kidney disease. Methods. We run a prospective cohort during January 2013 to January 2018, included all consecutive patients who underwent a kidney transplantation between January 2013 and February 2015 who accepted to participate. Sexual function was measured before transplantation, 6, 12 months after and at the last followup clinic (LOCF) by the International Index of erectile Function (IIEF) questionnaire in men and Female Sexual Function Index (FSFI) questionnaire in women. We assessed the evolution of the scores comparing to M0 (t test for paired profiles) in the overall population and by sex. Results. Ninety-two patients were included, 66 men and 26 women; average age 53years (+/-13). Median time between dialysis and transplantation was 22 months (IQR 13-34). Compared to M0, the average score increased by 13.3 points (+/-22.3) among the 55 patients who participated at M6 (95% confidence interval (95% CI), 7.2 to 19.3; p<0.0001), by 13.7 points (+/- 21.8) among the 32 patients who answered at M12 (95% CI, 5.9 to 21.6; p<0.0012) and by 5.8 points in the 76 patients at LOCF (95% CI, 10.9 to 19.5; p=0.03). When we analyzed by sex, median FSFI total score significantly increased in women at M6 (n=13, +9.1, p=0.03) but not at M12 (n=6, +8.9, p=0.13) or at LOCF (n=21, +3.3, p=0.13). In men, median IIEF total score significantly raised at M6 (n=42, +10.8, p=0.0002) and at M12 (n=26, +12.0, p=0.0034) but not at LOCF (n=55, +4.7, p=0.12). Conclusion. Our study supports that successful transplantation is the most effective means of restoring normal sexual function in both men and women with chronic kidney failure, probably because of an improvement of cardio-vascular and metabolic disorders.
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Mélanie Laguerre. Influence de la greffe rénale sur la sexualité. Médecine humaine et pathologie. 2018. ⟨dumas-02102195⟩

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